Long blog title I know. April 2011 there was a media blitz “Fat comes back after surgery, Study finds that liposuction is not a permanent fix,” as written in the New York Times.
This clearly got my attention, as it did of other doctors who do liposuction. Does the fat come back? And where?
The study is from the Obesity, 7 April 2011 journal by Drs Teri Hernandez and Robert Eckel, “Fat Redistribution Following Suction Lipectomy: Defense of Body Fat and Patterns of Restoration”. It is a prospective randomized controlled trial of suction lipectomy in nonobese women. The question? If you take women with fat pockets in their lower area (read hips/thighs) and do liposuction. where will you be in a year?
They had 32 patients. They found immediately after, the liposuctioned group had a lower body fat percentage (-2.1% vs -0.28%). This crept back up,so at one year there was little difference. Where the fat went had changed though- instead of going to the thighs (0.77% control, -1.81% lipo) , it went to the abdomen, back, and shoulders (0.64% control, 0.42% in lipo group).
The patients enrolled in the study agreed “not to make lifestyle changes while in the study.”
Thoughts?
I agree with this study –fat can come back after liposuction. Liposuction is not magic. It is not a weight loss technique. It is a sculpting technique. It changes where your fat goes to first.
Much of this study is not new news.
Did these patients lose weight? Gain weight? I have found for many when clothing fits well they don’t realize they have gained a few pounds. Particularly if the scale shows an equal weight as their presurgery weight… Liposuction is not a weight loss techniuqe, but if you do liposuction, you should lose a small amount of weight. The amount depends on how much fat was removed. If you do not lose any weight (ie you weigh the same as before surgery), you have in reality gained weight. (As we know, your fat will be stored in the untreated remaining fat storage areas. So if you only liposuction your thighs, you have fat storage areas remaining in your back, abdomen, breasts, buttocks, arms, etc. This is where your fat will go to first.)
Did these women have the expectation they should weigh a little less? Did these women have stable weights? Did they yo yo? Did they have a good exercise and eating regimen in place prior to surgery? Why was their weight not commented on in the press release? Both groups showed an increase in their abdominal post op measurement, and the lipo group was less than the control.
Why were these women treated only with small volume liposuction?
Why was the liposuction confined to one area? They did not have liposuction in multiple areas of the body. The study was just about removing the fat from the thighs. Please see my many blogs on the pitfalls of not evaluating your body as a whole. You want to address the major areas you accumulate fat when you do liposuction. “Spot treating” just your “outer thighs” or” love handles” will cause you to gain in other areas and create funny body shapes.
Finally, I read somewhere that all the women were offered liposuction after the study conclusion, including those placed in the control group. It said that half of the women in the control group chose to do liposuction.
So my conclusion? This is not much new news. Liposuction is not magic. You must have a good diet and exercise regimen in place. You must stick to the regimen. If you gain weight, it will go to the areas we did not do liposuction. You cannot assess fat and fat redistribution without looking at weight as part of the analysis. But I do think liposuction is something to be studied, and as with all studies. there is something to learn. This study stemmed from a finding they had in rodents where surgically removed fat returned. This study confirms liposuction alters where you gain weight. Does changing the pattern of fat distribution affect the body and your health? Does this study show there is some kind of brain link to regulating how much fat we have? And in patients who “fail” liposuction and regain the weight- is it due to this?
Fat cells are a new frontier of plastic surgery. Fat transfer. Fat as stem cells. Fat patterns. Keep on studying.